The Effect of Individualized Education on Learning Needs, Uncertainty in Illness, and Patient Activation among Patients Undergoing Hemodialysis: A Randomized Controlled Clinical Trial

Abstract

Abstract Introduction: Individualized education is one of the approaches that has garnered significant attention in recent years. There are limited studies on the effectiveness of this novel educational method in patients undergoing hemodialysis. This study aimed to examine the effect of Individualized education on patient learning needs, uncertainty in illness, and patient activation in patients undergoing hemodialysis. Methods: In this single-blind randomized clinical trial, 102 patients were randomly assigned to either the intervention or control group. Patients in the control group (n=51) received educational brochures provided by the hemodialysis center. Patients in the intervention group (n=51) received Individualized education based on their specific status, conditions, and educational needs in addition to the brochures provided to the control group, through in-person sessions ranging from three to six. The primary outcomes of the study included patient learning needs, uncertainty in illness, and patient activation, while secondary outcomes included hemodialysis adequacy (Kt/V) and intradialytic weight gain (IDWG). Data was collected using the Patient Learning Needs Scale (PLNS), Mishel’s Uncertainty in Illness Scale (MUIS), and the Patient Activation Measure (104) at three time points: before the intervention, immediately after the intervention, and three months after the last personalized education session. Data were analyzed using SPSS software (version 26) at a significance level of 0.05. Results: There was no significant difference in terms of sociodemographic and clinical characteristics and baseline scores of the study variables before the intervention between the groups (P>0.05). The study indicated that individualized education led to a decrease in patient learning needs and reduced uncertainty in illness in patients undergoing hemodialysis immediately and three months after the intervention (P<0.001). Additionally, this educational method resulted in an increase in patient activation levels immediately (P<0.001) and three months after the intervention (P<0.001). Moreover, this educational approach improved hemodialysis adequacy (Kt/V) immediately (P=0.04) and three months after the intervention (P=0.01). The average intradialytic weight gain was significantly lower in the intervention group compared to the control group immediately after the intervention (P=0.03) and three months after the intervention (P=0.02). Conclusions: Implementing an individualized education program for patients undergoing hemodialysis may help reduce patient learning needs, uncertainty in illness, and intradialytic weight gain. Furthermore, individualized education creates motivation for disease management, leading to improved patient activation and enhanced hemodialysis adequacy. Therefore, hemodialysis nurses can utilize individualized education as an effective method to meet patients' learning needs. However, further studies are necessary for definitive conclusions in this area.